DEPARTMENT OF STATE

Division of Professional Regulation

1900 Board of Nursing

1.0 General Provisions for the Operation of the Delaware Board of Nursing

These Rules and Regulations are adopted by the Delaware Board of Nursing by authority of the Delaware Nurse Practice Act, 24 Del.C. §1906(1).

1.1 Officers

The officers of the Board shall be the President and the Vice-President to be elected each year during the month of June and to assume their duties as of July 1.

1.1.1 The President of the Board shall:

1.1.1.1 Chair all regular and disciplinary hearings of the Board;

1.1.1.2 Represent the Board at the National Council of State Boards of Nursing (NCSBN) Delegate Assembly as a voting delegate, certain professional and/or community functions, and regional or national meetings, or shall designate a member or the Executive Director to represent the Board;

1.1.1.3 Sign all correspondence conveying rulings of the Board to nursing service agencies and educational institutions;

1.1.1.4 Execute those functions delegated to the President elsewhere in these rules and regulations, or otherwise by law;

1.1.1.5 Review the agenda for the Board meeting with the Executive Director prior to distribution.

1.1.2 The Vice-President of the Board shall:

1.1.2.1 Chair meetings and hearings in the absence of the President;

1.1.2.2 Execute those functions delegated to the Vice-President elsewhere in these rules and regulations, or otherwise by law;

1.1.2.3 Represent the Board at the NCSBN Delegate Assembly, and other meetings as delegated by the President or the Board, as a voting delegate.

1.1.3 Filling Vacancies:

1.1.3.1 In the event of a resignation, termination or departure of one of the officers, a replacement shall be elected at the next Board meeting or at a meeting called for that purpose. A quorum of the Board is required.

1.1.3.2 In the event one of the officers shall not be available to fulfill their duties for a period not exceeding three months, the Board shall nominate one of its members to serve for the interim period.

1.2 Members

1.2.1 All members appointed to the Board share the responsibility vested in the Board. The President of the Board shall consider qualifications and educational preparation in delegating certain duties to individual members of the Board.

1.2.2 Board members in executive session may review drafts of National Council Licensure Examination questions for Registered Nurses and Licensed Practical Nurses.

1.2.3 Two Board members, one a Registered Nurse and one a Licensed Practical Nurse, shall be chosen as alternate voting delegates to the NCSBN Delegate Assembly if one of the voting delegates can not attend.

1.2.4 The members of the Board shall attend all scheduled Board business meetings. If there are extenuating circumstances which prevent a member from attending all or part of a scheduled meeting, the Executive Director should be informed in writing, if time permits, or by telephone, in advance of the meeting.

1.2.5 All members are expected to be aware of and follow their obligations under the State Employees’, Officers’ and Officials’ Code of Conduct.

1.3 Duties of the Executive Director

1.3.1 The Division of Professional Regulation prescribes the duties of the Executive Director. See 29 Del.C. §8810(a).

1.4 Meetings

1.4.1 The Board of Nursing shall meet as often as necessary to transact the regular business of the Board.

1.4.2 Special meetings may be called at the request of the president or any two Board members.

1.4.3 An agenda shall be mailed to Board members prior to each meeting and notice of each meeting shall be given in accordance with the Freedom of Information Act.

1.4.4 The order of business for all regular meetings shall be:

1.4.4.1 Call to Order

1.4.4.2 Disposition of Minutes

1.4.4.3 Adoption of the Agenda

1.4.4.4 Activities Report

1.4.4.5 Unfinished Business

1.4.4.6 Committee Reports

1.4.4.7 President’s Report

1.4.4.8 Executive Director’s Report

1.4.4.9 Licensee Applicant Reviews

1.4.4.10 Licensee Reviews

1.4.4.11 Other Business

1.4.4.12 Licensee Approval

1.4.4.13 Next Meeting

1.4.4.14 Public Comment

1.4.4.15 Adjournment

1.4.5 Hearings shall be included in 1.4.4.10 for information purposes.

1.5 Requests for Meeting with the Board

1.5.1 The Board shall meet, upon request, with any group. The group asking for a meeting shall be asked to submit, in advance, items of interest for the agenda and shall receive a copy of the minutes. A request for a meeting shall be honored at the earliest convenience of the Board.

2.0 Nursing Education Programs

2.1 Definitions

“Board” the Delaware Board of Nursing.

“Conditional Approval” the status granted to a program that is determined to be deficient in a specified area. When this determination is made by the Board, written notice shall be sent to the program specifying the deficient areas, and the time limit within which the deficiencies are to be corrected.

“Full Approval” the status granted to a program that meets the requirements of the Law and the Rules and Regulations of the Board. Continuation of full approval is contingent upon annual review of the program and continuing to meet the criteria.

“Initial Approval” authorization to admit students and enter into contractual agreements for clinical facilities. It is granted only after an application has been submitted, reviewed and a survey visit made by the Board. No students shall be admitted to the program until the institution has received written notification that initial approval has been granted. Failure to comply will delay initial approval.

“National Accrediting Agency For Nursing Education” a national accrediting agency for nursing education that is recognized by the Council on Postsecondary Accreditation and by the U.S. Department of Education.

1 DE Reg. 1879 (6/1/98)

“Nursing Education Program” - as defined in 24 Del.C. Ch. 19.

2.2 Authority Designated to Board of Nursing

2.2.1 In accordance with 24 Del.C. Ch. 19, the Board may:

2.2.1.1 Approve curricula and develop criteria and standards for evaluating nursing education programs;

2.2.1.2 Provide for surveys of such programs at such time as it may deem necessary;

2.2.1.3 Approve such programs to meet the requirements of the Chapter and of the Board; and

2.2.1.4 Deny or withdraw approval from nursing education programs for failure to meet prescribed curriculum or other standards. (Subsections 1906 (b), (c), (e)).

2.3 Purposes of Approval

2.3.1 The state requires that nursing education programs be approved in order to:

2.3.1.1 Provide for the safe practice of nursing by setting minimum requirements for the programs that prepare the licensee.

2.3.1.2 Encourage self-evaluation for the improvement of a nursing education program.

2.3.1.3 Provide for the public a list of nursing education programs that meet the requirements set by the Board.

2.3.1.4 Assure the graduates of approved nursing programs of their eligibility to apply for admission to the licensing examination and to facilitate their licensure by endorsement in other states.

2.4 Procedure for Establishing a Nursing Education Program

2.4.1 Phase I

2.4.1.1 An administrative officer of the institution shall complete the appropriate application form and forward three copies to the Executive Director of the Board at least 12 months prior to enrollment of students.

2.4.1.2 The Board shall review the application and conduct a site visit. At least one of the visitors shall be a nurse educator who has curriculum expertise at the level of the program being reviewed.

2.4.1.2.1 Alternatively, the institution desiring to establish a nursing education program may elect to have the site visit made by a Board member(s) and a nursing education consultant, the latter with special expertise in the same type of nursing education as the program. The consultant shall be from a list of qualified persons approved by the Board. Costs associated with the visit of the consultant shall be borne by the nursing education program requesting same.

2.4.1.3 The purpose of the site visit is to validate the information recorded on the application.

2.4.1.4 The site visitation team shall make a written report to the Board.

2.4.1.5 The Board shall report to the institution within 90 days after all requirements of Phase I have been met.

2.4.2 Phase II

2.4.2.1 The institution shall notify the Board of the appointment of a qualified nurse as director of the program at least nine months in advance of the anticipated enrollment of students in nursing courses.

2.4.2.2 The director shall be responsible for planning the program and providing the information required in Part II of the application form, which must be resubmitted at least three months prior to the anticipated enrollment of students.

2.4.2.3 The Board shall review the application and supporting information at a regularly scheduled meeting and determine if the program is prepared to admit students. If it is so determined, initial approval will be granted.

2.4.3 Phase III

2.4.3.1 Following initial approval, the director of the program shall submit five copies of a progress report to the Board every six months. This shall be a general report of progress to date to include number of students enrolled, attrition rate, faculty credentials, curriculum design, and use of clinical facilities. After the admission of students, these reports shall continue to be submitted at six month intervals until discontinued by the Board.

2.4.3.2 The institution shall appoint other qualified nurse faculty members no less than four months in advance of enrollment of students in nursing courses to participate in determining the theoretical framework and in developing the curriculum plan and course content.

2.4.3.2.1 The program shall be developed according to criteria in accordance with 2.5 of these Regulations. The curriculum plan, including course descriptions, shall be submitted for Board review and approval three months in advance of enrollment of students in nursing courses.

2.4.3.3 Following the graduation of the first class, the nurse faculty shall prepare and submit five copies of a self evaluation report to the Board for review. The Board will conduct a survey visit to consider full approval of the program.

2.4.3.3.1 The Board’s decision regarding approval status shall be sent in writing to the appropriate administrative officers and to the director of the nursing education program.

2.5 Standards for Approval

2.5.1 Organization and Administration.

2.5.1.1 The school shall be authorized to conduct a nursing education program by charter or articles of incorporation of the controlling institution, by resolution of its board of control, or by the school’s own charter or articles of incorporation.

2.5.1.2 Universities, colleges, community or junior colleges, and public schools offering programs in nursing shall be accredited by their appropriate agencies.

2.5.1.3 Hospitals conducting a nursing education program shall be accredited by the Joint Commission on Accreditation of Health Care Organizations or the American Osteopathic Association.

2.5.1.4 Any agency or institution that is used by a nursing education program shall be authorized to conduct business in the state of Delaware, or in the state in which the agency or institution is located.

2.5.1.5 The authority and responsibility for the operation of the nursing education program shall be vested in a director who is duly licensed to practice professional nursing in Delaware and who is responsible to the controlling board, either directly or through appropriate administrative channels.

2.5.1.6 A written organization plan shall be prepared and submitted to the Board and shall indicate the lines of authority and communication of the program to the controlling body, other departments within the controlling institution, the affiliating and cooperating agencies, and to the advisory committee, if one exists.

2.5.1.7 Adequate funds shall be allocated by the controlling agency to carry out the stated purposes of the program. The director of the nursing program shall be responsible for budget recommendations and administration, consistent with the established policies of the controlling agency.

2.5.1.8 When the program uses educational or clinical resources that are under the control of another authority, there shall be written agreements with each resource provider. Such agreements shall be developed jointly with the provider, reviewed periodically according to the policies of the program and the agency, and include provision for adequate notice of termination.

2.5.1.9 Clerical services shall be provided to support the program with a minimum of one full-time secretary and additional secretarial staff as needed.

2.5.2 Philosophy and Objectives

2.5.2.1 Philosophy and objectives shall be clearly stated in writing.

2.5.3 Faculty

2.5.3.1 Minimum Qualifications

2.5.3.1.1 All nursing faculty members, including the director, shall hold current licenses to practice as Registered Nurses in Delaware.

2.5.3.1.2 The director and each member of the nursing faculty shall be academically and professionally qualified for the position to which appointed. All nursing faculty members shall maintain professional competence in their area(s) of teaching responsibility through professional development activities such as nursing practice, participation in professional meetings, workshops, formal college courses, and nursing research.

2.5.3.1.3 The director of a baccalaureate degree program shall hold an earned doctoral degree or have a specific plan for completing a doctoral degree and shall hold a degree in nursing at the Master’s level or higher. The director shall have experience in nursing practice, nursing education and shall give evidence of ability in providing leadership. A director employed by the school prior to the promulgation of these Rules and Regulations shall be exempt from this rule while remaining in the employ of that school.

2.5.3.1.4 The director of a nursing education program shall hold a minimum of a Master’s degree. The director shall hold a degree in nursing at the baccalaureate level or higher and shall have experience in nursing practice, nursing education and shall give evidence of ability in providing leadership. A director employed by the school prior to the promulgation of these Rules and Regulations shall be exempt from this rule while remaining in the employ of that school.

2.5.3.1.5 Each member of the nursing faculty shall hold a baccalaureate degree in nursing or a Master’s in nursing. Faculty employed by the school prior to the promulgation of these Rules and Regulations shall be exempt from this rule while remaining in the employ of that school.

2.5.3.1.6 Non-nurse members of the faculty shall hold academic and professional credentials in their field of specialization.

2.5.3.2 Number

2.5.3.2.1 The number of faculty members shall be sufficient to prepare the students for licensure, to achieve the objectives as stated in the school’s application, and reasonably proportionate to:

2.5.3.2.1.1 Number of students enrolled;

2.5.3.2.1.2 Frequency of admissions;

2.5.3.2.1.3 Education and experience of faculty members;

2.5.3.2.1.4 Number and location of clinical facilities; and

2.5.3.2.1.5 Total responsibilities of the faculty members.

2.5.3.3 Conditions of employment

2.5.3.3.1 Qualifications and responsibilities for faculty member positions shall be defined in writing.

2.5.3.3.2 Written personnel policies shall be consistent with the policies of the sponsoring institution.

2.5.3.3.3 Faculty assignments shall allow time for class and laboratory preparation, teaching, program evaluation, improvement of teaching methods, guidance of the students, participation in faculty organizations and committees, attendance at professional meetings, and participation in continuing education activities.

2.5.3.4 Functions

2.5.3.4.1 The principal functions of the faculty shall be to:

2.5.3.4.1.1 Develop the philosophy and objectives of the nursing program;

2.5.3.4.1.2 Develop, implement, evaluate and revise the curriculum;

2.5.3.4.1.3 Participate in the recruitment, admission and retention of students in the nursing program;

2.5.3.4.1.4 Establish criteria for promotion and completion of the program in nursing;

2.5.3.4.1.5 Evaluate student achievement on the basis of established criteria;

2.5.3.4.1.6 Recommend successful candidates for degree, diploma and other forms of recognition; and

2.5.3.4.1.7 Participate in appropriate activities of the controlling institution.

2.5.3.5 Organization

2.5.3.5.1 The nursing faculty shall attend regular meetings of the faculty for the purpose of developing, implementing and evaluating the nursing curriculum.

2.5.3.5.2 Committees shall be established as needed.

2.5.3.5.3 Written rules or bylaws shall govern the conduct of nursing faculty meetings and committees.

2.5.3.5.4 Minutes of faculty and committee meetings, including action taken, shall be recorded and available for reference.

2.5.3.5.5 Provision shall be made for nursing student membership and participation on faculty committees and in committee meetings as appropriate.

2.5.3.5.6 Where nursing practice/education (advisory) committees are established, their functions and relationship to the board of control and to the program shall be clearly defined

2.5.3.5.7 Written rules shall govern the activities of the nursing practice/education (advisory) committee(s) and minutes of the meetings shall be on file in the administrative office of the program.

2.5.4 Students

2.5.4.1 Admission, Promotion and Graduation

2.5.4.1.1 Criteria

2.5.4.1.1.1 Policies and procedures related to the selection and admission of students are the responsibility of the individual school.

2.5.4.1.1.2 Students shall be admitted on the basis of established criteria and without discrimination as to age, race, religion, sex, sexual preference, national origin, or disability.

2.5.4.1.1.3 There shall be written policies for the admission and re-admission of students.

2.5.4.1.1.4 Schools granting advanced standing after admission via challenge examinations, College Level Examination Program, teacher made tests or any other method shall have written criteria for granting course credit.

2.5.4.1.1.5 The policies for promotion, retention and graduation shall be published in the school catalogue or in other appropriate documents that are available to students.

2.5.4.1.1.6 All candidates in a program that requires applicants to be registered nurses must be licensed in Delaware if any clinical experiences occur in the State.

2.5.4.2 Services

2.5.4.2.1 There shall be written policies for student welfare as related to health, counseling and guidance, financial aid, and residence life, if offered.

2.5.4.2.2 There shall be well-defined written policies governing payment and refund of tuition and other fees.

2.5.5 Information

2.5.5.1 Annual Report

2.5.5.1.1 By October 1 of each year, five copies of an annual report of the nursing education program shall be sent to the Board, using the format supplied by the Board. The report will include information from August 1 of the previous year through July 31 of the current academic year.

3 DE Reg. 1373 (4/1/00)

2.5.5.2 School Records

2.5.5.2.1 A nursing education program shall maintain a system of records which shall contain all data relating to approval by any agency or body. The data shall include, but not be limited to, course outlines, minutes of faculty and committee meetings, pertinent correspondence, reports of standardized tests and survey reports. Such data shall be available to the Board representatives during the course of a site survey visit subject to applicable provisions of state and federal law.

2.5.5.3 Student Records

2.5.5.3.1 The school shall maintain a record for each student. Subject to applicable provisions of law, such records shall be available to Board representatives during the course of a site survey visit.

2.5.5.3.2 A final transcript for each student shall be retained in the permanent records of the school.

2.5.5.3.3 Provision shall be made for the protection of records against loss, destruction and unauthorized use.

2.5.5.4 School Bulletin or Catalogue

Current information about the school shall be published periodically and distributed to students, applicants for admission and to the Board. It should include a general description of the program, philosophy and objectives of the controlling institution and of the nursing programs, admission and graduation requirements, fees, expenses, and financial aid, educational facilities, living accommodations, student activities and services, curriculum plan, course descriptions, and faculty staff roster.

2.5.6 Curriculum

The following shall apply to nursing education programs:

2.5.6.1 Nursing Education Programs

2.5.6.1.1 The curriculum shall reflect the stated philosophy and objectives of the school and evidence of an organized pattern of instruction and appropriate supervised nursing practice consistent with sound educational practices and principles of learning.

2.5.6.1.2 LPN and RN programs shall provide for concurrent or correlated theory and clinical practice in the physical and/or mental health care of individuals of all ages, the nursing care of mothers and newborns, children, adults, the aged, individuals with mental health problems, and individuals in diverse settings, not necessarily in separate courses.

2.5.6.1.2.1 Clinical experiences shall include preventive aspects of illness, nursing care of persons with acute and chronic illnesses and rehabilitative care. Opportunities shall be provided for the student to participate in patient teaching in a variety of settings with individuals, families and other groups.

2.5.6.1.2.2 Concurrent and or correlated theory shall include the history of nursing, health care issues, and legal-ethical issues.

2.5.6.1.3 The RN curriculum shall provide instruction in the following fields:

2.5.6.1.3.1 Physical and biological sciences including content from the areas of anatomy and physiology, chemistry, microbiology, pharmacology and nutrition, which may be integrated, combined or presented as separate courses, and

2.5.6.1.3.2 Social and behavioral sciences including content drawn from the fields of communication theory, psychology and sociology and shall serve as a basis for the selection of learning experiences which develop abilities and skills in observation, interviewing, interpersonal relations, and problem-solving.

2.5.6.1.3.3 Professional nursing responsibilities.

2.5.6.1.3.4 Nursing research and nursing leadership in BSN programs.

2.5.6.1.4 The LPN curriculum shall provide instruction in the following fields:

2.5.6.1.4.1 Essential facts and principles in the biological, physical and social sciences including body structure and functions, elementary microbiology, pharmacology and nutrition, signs of emotional and mental health, human growth and development, and administration of medications.

2.5.7 Evaluation

2.5.7.1 Evaluation as a basis for curriculum revision and change in practices is a continuous process and an inherent responsibility of the faculty. The degree to which the faculty accomplishes its objectives shall be determined through evaluation of curriculum content, teaching methodologies, clinical and other learning experiences, student progress, success of graduates on the licensing examination, promotion, retention and degree of nursing competence of the graduate.

2.5.8 Educational Facilities

2.5.8.1 Classrooms, laboratories, and conference rooms shall be adequate in number, size and type for the number of students and educational purposes for which the rooms are used.

2.5.8.2 Offices

2.5.8.2.1 Offices shall be available and adequate in size, number and type to provide faculty with opportunities for uninterrupted work and privacy for conferences with students.

2.5.8.2.2 Space for clerical staff, records, files and other equipment shall be adequate for the needs of the program.

2.5.8.3 Learning Resources

2.5.8.3.1 The library shall have recent, pertinent and sufficient holdings to meet the learning needs of students and faculty.

2.5.8.3.1.1 Provision shall be made for regular additions to and deletions from the library collection.

2.5.8.3.1.2 Library facilities and policies shall be conducive to effective use.

2.5.8.3.2 Equipment shall be available so that a multimedia approach to learning is afforded.

2.5.8.4 Clinical Facilities

2.5.8.4.1 The clinical facility to which the student is assigned for clinical practice is considered an integral part of the nursing program.

2.5.8.4.1.1 Clinical facilities shall be selected by the faculty to provide learning experiences essential to achieve the stated purposes of the program and the stated objectives for each clinical course. They may include, but are not limited to:

2.5.8.4.1.1.1 Inpatient facilities such as acute care hospitals, specialized hospitals, long term and extended care facilities.

2.5.8.4.1.1.2 Outpatient facilities such as hospital based clinics, community health centers, mental health clinics and physicians’ offices.

2.5.8.4.1.1.3 Other community agencies such as hospices, health maintenance organizations, day care centers, senior centers and prisons.

2.5.8.4.1.2 The following criteria for clinical facility use must be met:

2.5.8.4.1.2.1 There shall be an environment in which effective learning can take place and in which the student is recognized as a learner.

2.5.8.4.1.2.2 There shall be an adequate number of qualified professional and other nursing personnel not including the student, to ensure safe care of the patient.

2.5.8.4.1.2.3 There shall be a sufficient number and variety of patients to provide adequate learning experiences.

2.5.8.4.1.3 Hospital facilities shall be accredited by the Joint Commission on Accreditation of Health Care Organizations or the American Osteopathic Association. Other facilities such as specialized hospitals, long term and extended care facilities and community health agencies shall be licensed or approved by the appropriate approving authority.

2.5.8.4.1.4 Facilities used for clinical experience shall be approved by the Board prior to the assignment of students. Approval shall be based on information provided by the school on forms furnished by the Board. A visit by Board representatives to the clinical site may be scheduled.

2.5.8.4.1.5 Clinical facilities used in another state require written notification to that jurisdiction’s Board of Nursing.

2.5.8.4.1.6 Written agreements between the school and agencies involved shall:

2.5.8.4.1.6.1 Ensure that the faculty are ultimately responsible for the students’ learning experiences.

2.5.8.4.1.6.2 Provide for continuous planning for students in cooperation with the director of nursing and appropriate nursing staff of the agency.

2.5.8.4.1.6.3 Provide adequate space for the number of students and faculty to conduct educational conferences.

2.5.8.4.1.7 Observational experiences shall be planned in cooperation with the agency to meet stated objectives.

2.5.9 Program Changes

2.5.9.1 Program Changes Requiring Board of Nursing Prior Approval

2.5.9.1.1 Changes in the philosophy and/or objectives of the program.

2.5.9.1.2 Changes in the overall curriculum plan.

2.5.9.1.3 Changes in the administrative sponsorship of the program.

2.5.9.2 Procedure for Approval of Program Change

2.5.9.2.1 When a program change is contemplated, consultation from the Board is available.

2.5.9.2.2 When any program change is proposed, a written plan shall be submitted to the Board including the:

2.5.9.2.2.1 Description of the change

2.5.9.2.2.2 Rationale for the change

2.5.9.2.2.3 Relationship of the proposed change to the present program.

2.5.9.3 Three copies of these materials shall be submitted to the Board at least one month prior to the Board meeting at which time the request will be considered.

2.5.10 Procedure for Continuing Full Approval

2.5.10.1 Each nursing education program that is accredited by a Board-approved national accrediting agency for nursing education must submit a copy of the self-study document and the letter of notification of accreditation status by October following the reaccredidation visit. This is contingent on the program remaining accredited and sharing copies of all correspondence related to compliance with the national accrediting agency’s recommendations. Extraneous material will be disseminated to Board Members at the discretion of the Executive Director in consultation with the President.

1 DE Reg. 1883 (6/1/98)

3 DE Reg. 1373 (4/1/00)

2.5.10.2 Each nursing education program that does not have Board approved national accreditation will be re-evaluated at least every five years. Survey visits may be scheduled as determined by the Board.

1 DE Reg. 1884 (6/1/98)

2.5.10.2.1 Representative(s) of the Board will conduct a survey visit on a date mutually acceptable to the nursing program and the Board.

2.5.10.2.2 The Board shall notify the director of the nursing education program of the intended survey visit by June of the year preceding the survey visit. The Director shall coordinate an agenda for the visit with the Board and submit it to the Board office three weeks prior to the visit for distribution to the team.

2.5.10.2.3 The school shall submit five copies of a comprehensive self-evaluation report, following the format supplied by the Board, by October 1 of the survey year.

3 DE Reg. 1373 (4/1/00)

2.5.10.3 Interim visits may be made at any time within the five-year period either by request or as deemed necessary by the Board, with advance notice. At least one of the visitors shall be a nurse educator who has curriculum expertise at the level of the program being reviewed.

2.5.10.4 If the Board determines that a program is not maintaining the standards of Section 2.5 of these Rules and Regulations, the program shall be granted conditional approval and given a reasonable period of time to correct deficiencies.

2.5.10.5 A failure to attain an eighty percent pass rate on the licensure examination for first time candidates as reflected in two consecutive annual reports will require presentation to the Board of a plan to identify and correct deficiencies. Progress reports will be required.

2.5.10.5.1 A program reporting five or fewer candidates in a 12 month period with a failure to attain an eighty percent pass rate as reflected in two consecutive annual reports must provide a written explanation to the Board for action.

2.5.10.6 Deficiencies sufficient to warrant a determination of conditional approval (probation) may include one or more of the following:

2.5.10.6.1 Failure to adhere to the school’s stated philosophy and curriculum objectives.

2.5.10.6.2 Repeated violations of stated academic and/or admission policies.

2.5.10.6.3 Failure to maintain a faculty and administration of adequate size and qualifications.

2.5.10.6.4 Use of students for nursing services or other purposes that are not primarily educational.

2.5.10.6.5 Failure to provide adequate resources for cognitive learning and clinical practice.

2.5.10.6.6 Failure to admit and retain students and/or hire and promote faculty and other personnel without discrimination as to age, race, religion, sex, sexual preference, national origin, or disability.

2.5.10.6.7 Failure to attain an eighty percent pass rate on the licensure examination for first time candidates in any three consecutive calendar years.

2.5.10.6.8 Any other deficiencies that, in the opinion of the Board, detrimentally affect the educational process.

2.5.10.7 Upon notification of conditional approval (probation), the program administrator shall submit an action plan no less than two weeks preceding the Board meeting designated in the notification. The action plan shall include identification of the deficiency(ies), proposed corrective action, and projected timeline to remediate the deficiency(ies). The program administrator will be invited to present the action plan at the designated Board meeting. The Board may approve the plan as submitted, recommend revisions, or reject the plan. The program shall submit progress reports as specified by the Board during the term of conditional approval (probation). Prior to the expiration of the probationary period, the program administrator will be invited to meet with the Board to review the status of the plan relative to remediation of the deficiency(ies). A program becomes eligible for unconditional approval when the Board is satisfied that the stated deficiency(ies) has been corrected. If satisfactory remediation has not occurred in the stated timeline, the program administrator will submit an explanation and revised plan with projected timeline. The Board may approve the plan as submitted, or with revisions, or reject the plan and propose to withdraw program approval.

3 DE Reg. 1373 (4/1/00)

2.5.10.8 A program that fails to correct these deficiencies to the satisfaction of the Board within a reasonable time shall be discontinued after a hearing in which facts regarding such deficiencies are established.

3 DE Reg. 1373 (4/1/00)

2.5.10.9 Provisions of Rules 2.6.1.1.2, 2.6.1.1.2.3, 2.6.1.1.2.4, and 2.6.1.1.2.5 shall prevail for any program for which Board approval has been discontinued.

3 DE Reg. 1373 (4/1/00)

2.6.1 Termination of a Nursing Program

2.6.1.1 The controlling institution shall:

2.6.1.1.1 Submit written notification to the Board of its intent to terminate or interrupt the nursing program.

2.6.1.1.2 Provide for the completion of the nursing program for all students currently enrolled.

2.6.1.1.3 Safeguard the quality of the educational program for these students.

2.6.1.1.4 Provide for the permanent retention of records of students and graduates.

2.6.1.1.5 Notify the Board in writing as to the location of records and where requests for records may be sent.

2.7.1 Procedure for Annual Review of Nursing Education Programs

2.7.1.1 The Board shall review the annual reports and self-evaluation reports of the programs to be submitted each October 1.

3 DE Reg. 1373 (4/1/00)

2.7.1.2 Following review of the reports from the programs, written notification of the action taken at the regularly scheduled board meeting, including any recommendations, shall be sent to the appropriate administrative officers of the school. This could include notification of the Board’s intention to conduct a site visit.

2.7.3 Site Visits

2.7.3.1 For any site visit, the President shall designate the Board members who are to make the survey visits and the chair person of the survey team. At least one member of each team shall be a nurse educator who has curriculum expertise at the level of the program being reviewed.

2.7.3.2 The site visit may be made by a Board member(s) and a nursing education consultant, the latter with special expertise at the same level of nursing education as the program. The consultant shall be selected from a list of qualified persons submitted by the nursing program and approved by the Board. Costs associated with the hiring of the consultant shall be borne by the program.

2.7.3.3 The Board will indicate in advance any clinical areas they wish to visit.

2.7.3.4 The school shall schedule separate interviews for the visitors with:

2.7.3.4.1 The nurse administrator of the program

2.7.3.4.2 The faculty

2.7.3.4.3 Representative students from each level

2.7.3.4.4 Others as deemed appropriate by the agency or the Board.

2.7.3.5 The school shall have records available for visitor review, including:

2.7.3.5.1 Committee minutes

2.7.3.5.2 Course materials

2.7.3.5.3 Evaluation data regarding the entire program

2.7.3.5.4 Other materials as specified by the survey team.

(Approved 11/8/95)

(Revised 7/8/98)

3.0 Nursing Refresher Courses

3.1 Statement of Purpose

A nursing refresher course is required for Registered and Licensed Practical Nurses who are presently ineligible for endorsement or reinstatement of licensure because they have been inactive in nursing practice for five or more years.

3.1.1 Nurses successfully completing a refresher course may apply for licensure by reinstatement and may resume active practice.

3.1.2 An orientation program does not take the place of a refresher course.

3.2 Course Content

3.2.1 The design of the course shall emphasize adult teaching/learning methods wherein the learner is responsible for considerable self-study under the guidance of the faculty.

3.2.2 Course content for both Registered/Licensed Practical Nurses shall include but not be limited to concepts from the following areas: nursing care of mothers and newborns, children, adults, the aged, and individuals with mental health problems, and shall include:

3.2.2.1 current professional/practical nursing trends,

3.2.2.2 legal aspects of professional/practical nursing,

3.2.2.3 the nursing process,

3.2.2.4 communication skills,

3.2.2.5 pharmacology,

3.2.2.6 fluid and electrolytes

3.2.2.7 commonly used lab tests and values,

3.2.2.8 nutrition,

3.2.2.9 Basic Life Support, and

3.2.2.10 basic nursing procedures

3.2.3 The Registered Nurse course content shall also include:

3.2.3.1 physical and mental assessment, and

3.2.3.2 crisis intervention,

3.2.4 The refresher course for the Registered Nurse shall have a minimum of 20 hours of theory and a minimum of 40 hours of clinical practice.

3.2.5 The Licensed Practical Nurse course content shall also include:

3.2.5.1 The Licensed Practical Nurse’s relationship to the health care team.

3.2.6 The refresher course for the Licensed Practical Nurse shall have a minimum of 15 hours of theory and a minimum of 30 hours of clinical practice.

3.2.7 Each course shall include sufficient theory and supervised clinical practice to meet the course objectives.

3.3 Clinical Facilities

3.3.1 The clinical facilities shall be:

3.3.1.1 Able to support the necessary clinical practice.

3.3.1.2 Accredited.

3.3.1.3 Approved by the Board of Nursing.

3.3.1.4 Acute and/or long-term care.

3.4 Faculty Qualifications

3.4.1 The director and/or faculty of the course shall be a Registered Nurse licensed in Delaware with a minimum of a baccalaureate degree in nursing.

3.5 Evaluation

3.5.1 There shall be an evaluation that will measure acquisition of the knowledge, skills and abilities needed to return to active nursing practice.

3.5.2 Evaluation tools that may be used include:

3.5.2.1 Written examination

3.5.2.2 Evaluation of clinical competence

3.5.2.3 Written required graded assignments

3.5.3 The course coordinator shall verify to the Board of Nursing in writing that each nurse participant has successfully completed the refresher course.

3.6 Procedure for Approval and Continuing Approval

3.6.1 Refresher courses offered to meet requirements for professional or practical nurse licensure, renewal, endorsement, reinstatement or reactivation shall be approved by the Board prior to student enrollment.

3.6.2 Applications for course approval shall be submitted to the Board at least ninety days prior to the starting date.

3.6.3 Applications for approval shall include:

3.6.3.1 Name of institution offering the program

3.6.3.2 Type of program:

3.6.3.2.1 Registered Nurse refresher program

3.6.3.2.2 Licensed Practical Nurse refresher program

3.6.3.3 Faculty and their qualifications

3.6.3.4 Course outline, including:

3.6.3.4.1 Theoretical and clinical objectives

3.6.3.4.2 Course content

3.6.3.4.3 Hours of theory and practice

3.6.3.4.4 Facilities used for clinical practice

3.6.3.4.5 Evaluation procedures

3.6.4 Approval shall be considered after the program has been reviewed and has met the standards of the Board. Written notification of the action taken at a regularly scheduled board meeting, including any recommendations, shall be sent to the appropriate administrative officers of the program. A site visit may be made at the discretion of the Board.

3.6.5 When any program change(s) is projected, plan shall be submitted to the Board including:

3.6.5.1 Proposed change(s)

3.6.5.2 Rationale for the change(s)

3.6.5.3 Relationship of the proposed change(s) to the present program(s)

Five copies of these materials shall be submitted to the Board at least one month prior to the Board meeting at which the request will be considered.

3.6.6 The institution shall submit five copies of an Annual Report every September 1.

3.6.7 Every three years on September 1 of the due year the institution shall submit five copies of a comprehensive self-evaluation report, based on the requirements for approval as stated by the Board.

3.6.7.1 A survey visit may be made at the Board’s discretion.

4.0 Alternate Supervised Practice Plan for Nurses Inactive in Practice Five or More Years If No Refresher Course Is Available.

4.1 Introduction

4.1.1 Nursing and the health care field have undergone many changes in the past two decades. Most nurses who are reentering practice after a period of inactivity of five or more years need to be oriented to changes that may have an impact on their role and the competency of their practice.

4.2 Statement of Purpose

4.2.1 To provide opportunities for a nurse who is presently ineligible for endorsement of licensure, reinstatement of licensure, or renewal of licensure because the nurse fails to satisfy the 1000 practice hours in the past five years or a minimum of 400 nursing practice hours in the past two years, to review and update nursing knowledge and skills in order to become licensed and resume active practice.

4.2.2 This alternate supervised practice plan applies only if a Delaware Board of Nursing approved refresher course in nursing is not available within a reasonable distance or time.

4.3 Procedural Guidelines

4.3.1 The participating facility must be no less than a skilled nursing facility as defined by the Office of Health Facilities Licensing and Certification.

4.3.2 Upon agreeing with an applicant to provide a period of supervised practice for the assurance of minimal competency, the Director of Nursing of the employing agency shall verify this agreement in a letter on agency stationary to the Board.

4.3.3 Upon receipt of verification of this supervised practice, a temporary permit to practice will be issued by the Board to the nurse for presentation to the health care institution. The clinical experience evaluation form will be sent to the health care institution providing this supervised practice opportunity.

4.3.4 The Director of Nursing shall designate a single Registered Nurse to provide the supervised clinical nursing practice of no less than 240 hours. The assigned nurse who provides the supervision is accountable for the quality of the supervised experience and for accurate assessment of the competence of the applicant.

4.3.5 The Board shall issue a letter of authorization to each applicant upon approval.

4.3.6 Upon completion of the required hours, the supervising nurse shall submit a completed agency evaluation form.

4.3.7 The Director of Nursing shall submit a statement confirming satisfactory completion of the supervised plan, and a recommendation related to the licensure reinstatement of the applicant.

4.3.8 Based on the submitted documentation, the Board will issue a license or a letter of intent to deny licensure.

5.0 Guidelines for Courses Related to Assistance with Medications 24 Del.C. 1902

5.1 Definition

“Assistance with medications” means a situation where a designated care provider functioning in a setting authorized by 24 Del.C. §1921 of this Chapter, who has taken a Board approved medication training program, or a designated care provider who is otherwise exempt from the requirement of having to take the Board approved self administration of medication training program, assists the patient in self-administration of medication other than by injection, provided that the medication is in the original container with a proper label and directions. The designated care provider may hold the container for the patient, assist with the opening of the container, and assist the patient in taking the medication.

5.2 Procedure for Administering Training Course

5.2.1 Three copies of each proposed medication training course shall be submitted to the Board for approval or advance notice made to the Board that the approved core training program will be used.

5.2.2 Credentials of all instructors shall be submitted to the Board for approval.

5.2.3 Upon completion of the course, the instructor shall submit a list of the successful students to the Board.

5.3 Provider Qualifications

5.3.1 Upon completion of this assistance with self-administration of medications training course, the designated care provider will be able to meet the objectives as indicated in the Board approved course guidelines.

5.3.2 Designated care providers will be recertified as specified by the Board of Nursing.

5.4 Annual Reporting

5.4.1 The administrator of the program shall submit an annual report to the Board of Nursing by August 1 on a form provided by the Board.

3 DE Reg. 1373 (4/1/00)

5.4.2 The report shall indicate compliance with the guidelines as set forth in the Board approved assistance with administration of medication training program.

6.0 Requirements and Procedures for Licensure

6.1 Examinations

6.1.1 The Board declares that the National Council Licensure Examination-RN (NCLEX-RN) and the National Council Licensure Examination-PN (NCLEX-PN) are the required examinations for licensure in Delaware. The Division of Professional Regulation has the authority to review and approve the content and validity of examinations.

6.1.2 Up to July 1982, the passing score for professional nurse candidates was a standard score of 350 on each test of the State Board Test Pool Examination.

6.1.3 Effective July 1, 1982, the passing score for Registered Nurse candidates was 1600 on the NCLEX-RN and 350 on NCLEX-PN.

6.1.4 Effective July 1, 1988, results are reported and recorded as pass or fail.

6.1.5 The candidate shall take the licensing examination within 90 calendar days following graduation from a Board approved program of professional or practical nursing and not there after without petitioning the Board for specific authorization to test after the 90 day period. Such petitions may be granted by the Board upon a showing of good cause.

3 DE Reg. 1373 (4/1/00)

6.1.6 To be eligible to take the examination for licensure for practical nursing, the applicant must be a graduate of a Board approved program for practical nursing. A graduate of a program for professional nursing will be denied permission to take the examination for licensure as a practical nurse.

6.1.7 The candidate shall file two applications for each examination.

6.1.7.1 The NCLEX ap